Abstract
Femoral bifurcation and tibial hemimelia are rare anomalies described as a variant of Gollop-Wolfgang complex. This article presents a case of Gollop-Wolfgang complex without hand ectrodactyly. A 5-year old patient presented with bilateral tibial hemimelia and left femoral bifurcation. The patient's left limb lacked knee extensor mechanism, disarticulation was done. The right leg which had Jones type 2 tibia hemimelia was treated with tibiofibular synostosis. Currently patient is ambulant with prosthesis on the left limb and ankle foot orthosis on the right. In the absence of proximal tibial anlage, especially in patients with femoral bifurcation, the knee should be disarticulated. Tibiofibular synostosis is a good choice in the presence of a proximal tibial anlage with good quadriceps function.
Highlights
Tibial hemimelia, either partial or complete, is a very rare anomaly with an incidence of one in one million live births [1]
In 1984, Wolfgang [5] reported a single case of tibia hemimelia with ipsilateral femoral bifurcation and contralateral diastasis of the tibia
In 1986, the eponym 'GollopWolfgang complex' was introduced by Lurie and Ilyina [6] as they concluded that the association of hand ectrodactyly and femoral bifurcation is not coincidental
Summary
Either partial or complete, is a very rare anomaly with an incidence of one in one million live births [1]. The left hip joint was normal; right lower limb: the leg was shortened with severe equinovarus deformity of the feet. She had active knee extension with full range of motion. Radiographs revealed left distal bifid femur with complete tibia deficiency and right partial distal tibia deficiency (Figure 1) Both upper limbs were normal and on further evaluation the child did not have any visceral or congenital cardiac anomalies. In August 2014 left knee disarticulation was done with excision of the medial branch of bifid femur Three years later she was doing well ambulating with left limb prosthesis and right ankle foot orthosis (Figure 3)
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